People who smoke electronic cigarettes often don't think of it as smoking at all — the preferred term is "vaping," a reference to the small, battery-operated devices that heat nicotine into a vapor that's inhaled.
The gadgets, which have been on the market for four years, mimic the look of cigarettes, but because they contain no tobacco and far fewer chemicals are widely seen as safer. Yet as prices drop and more people are using them to quit smoking or circumvent smoke-free laws, new studies are questioning their use. Researchers say they may addict kids to nicotine or irritate bystanders with their vapor, but the industry says they do far more good than harm.
Young adults view the new nicotine-containing products positively and half say they'd try them if offered by a friend, particularly because they come in flavors, according to a University of Minnesota study published last month online in the American Journal of Public Health. Researchers interviewed 66 Americans, ages 18 to 26, about snus (a Swedish type of smokeless tobacco), dissolvable tobacco products and e-cigarettes, which come in bubble gum, cherry and chocolate flavors.
"There's a danger e-cigarettes could lure in kids who might not otherwise smoke," says anti-smoking activist John Banzhaf, a professor at the George Washington University Law School in Washington, D.C. He pushed for the Food and Drug Administration to regulate them.
The FDA, after finding trace amounts of toxic and carcinogenic ingredients in several samples, sought to regulate e-cigarettes as drug delivery devices. A federal judge ruled in 2010 that it lacked such authority, so the FDA is moving to regulate them as tobacco products.
"Many people use them as a bridge product" to avoid smoke-free laws — and as a result, they delay or avoid quitting, says David Abrams, executive director of the Shroeder Institute, operated by the anti-tobacco group Legacy. He co-authored a study in the same issue of the public health journal that found 70% of Americans believe e-cigarettes are less harmful than regular cigarettes.
A third peer-reviewed study found that e-cigarettes may emit aerosols, VOCs (volatile organic compounds) and nicotine, posing a "passive vaping" risk to bystanders. The study, by German researchers, appeared in July in Indoor Air.
Nonsense, an industry group says. "There's no smoke. It's water vapor. You don't smell anything," says Thomas Kiklas, director of the Tobacco Vapor Electronic Cigarette Association. "There's no there there" to the argument of harmful vapor, he says.
Kiklas says e-cigarettes contain only five ingredients: nicotine, water, glycerol, propylene glycol (used in inhalers) and flavorings. He says the samples FDA tested a few years ago had minuscule amounts of other ingredients, but the products have improved.
He says U.S. retailers try not to sell to kids, and he rebuffs the argument that sweet flavorings are meant to lure them, adding nicotine gum also comes in cherry. "Our demographic is 40 and above," he says.
"The amount of good we're doing is phenomenal," he adds, because the devices help thousands of people quit cigarettes. "The technology works. Smokers have embraced it."
Celebrities, so often trendsetters, have been seen vaping on screen. In The Tourist,Johnny Depp took puffs from a slim stick, saying, "It's not a real cigarette — it's electronic."
On the Late Show in 2010, actress Katherine Heigl whipped out her electronic cigarette, telling David Letterman it helped her stop smoking: "You're blowing out water vapor, so you're not harming anyone around you and you're not harming yourself.
Even some in the medical community see possible benefits: "E-cigarettes may hold promise as a smoking cessation method," concluded Michael Siegel of the Boston University School of Public Health in a study published in April 2011 in the American Journal of Preventive Medicine.
He and two co-researchers found that two-thirds, or 67%, of the 222 smokers queried said they smoked less after using e-cigarettes for six months and nearly a third, or 31%, said they kicked the tobacco habit.
Others are more skeptical. "We're not saying they're safe or unsafe. We just don't know. The responsible research needs to be done," Abrams says, adding that FDA-approved nicotine replacement devices have been thoroughly tested.
His Legacy colleague, pulmonologist Nathan Cobb, says there are quality control issues with e-cigarettes, almost all of which are imported from China. He says nicotine levels vary widely and contamination can occur with propylene glycol, which is used in a variety of products including inhalers and as an antifreeze.
"We're still trying to understand what happens when people inhale them," Cobb says. As for smoking cessation, he says, "Some e-cigarettes might be effective, some might not."
What's clear, though, is the upward trend in e-cigarette use and the downward spiral in its costs, now making it a less expensive alternative to cigarettes. Based on reports from factories and members of his organization, Kiklas expects U.S. sales this year of about 5 million, this for a product that first got on the market in 2008.
Each e-cigarette has three parts: battery, charger and cartridge, which contains the nicotine and other ingredients.
Each unit now sells for about $21, down from at least $200 three years ago, says Jerry Newton, owner of Earth N Ware in Orange County, Calif., which sells them and cigarettes. He says his replacement cartridges, which provide about as much nicotine as a pack and a half of cigarettes, cost $3 each.
Unlike cigarettes, these devices are not federally taxed, although some states are moving to impose their own taxes. An increasing number of cities and states are banning e-cigarette use in smoke-free places. Amtrak has banned its use on trains, and the Navy banned it below decks in submarines. In September, the U.S. Department of Transportation proposed a ban aboard airplanes because of concerns about health risks from the vapors.
Some who use them find them helpful. Newton, 63, says he was a chain smoker for 51 years despite repeated efforts to quit. On Aug. 16 last year, when he started using the electronic device, he took his last smoke from a real cigarette.
"My brain thinks it's still smoking," he says, referring to the nicotine effect he gets from e-cigarettes. "But my smokers' cough is gone. I feel a lot better."

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